Why does the rhythm method fail 15-25% of the time?
Cycle variability and prolonged sperm survival in cervical mucus (up to 7 days)
How do IUDs work?
Sperm destroyed by PMNs (esp. copper), thickens cervical mucus (progestin), inhibits ovulation and thins endometrial lining w/decreased menstrual lining.
No systemic hormone exposure, lower menstrual blood loss, decreased risk for endometrial cancer and can be used during breast feeding.
Acne, uterine perforation and pelvic infection
Drug that looks like progesterone, is injected into the muscle, lasts several months by inhibiting ovulation, thickening cervical mucous and thinning endometrial lining.
Depo Provera (provides constant progestin exposure)
Benefits of Depo Provera
Decreases anemia (less menstruation), decreased PID (thickened cervical mucous), decreased ectopic pregnancy (decreases all pregnancy), decreased endometrial cancer and can be used during breast feeding.
Side effects of Depo Provera
Irregular menstrual bleeding, acne, mood changes, headache and maybe weight gain.
Mechanism of action of oral contraceptives?
Estrogen component: inhibits mid-cycle LH surge so ovulation doesn’t occur and decreases glycogen production in endometrium. Progestin component: thickens cervical mucous and disrupts tubal uterine motility.
Benefits of oral contraceptives
Decreased menstrual blood loss, decreased PMS, decreased acne (estrogen component), decreased ectopic pregnancy, decreased functional cysts and decreased PID.
Side effects of oral contraceptives
Cervical dysplasia, thromboembolism, breast tenderness, nausea and fluid retention.
How do circular silastic capsule releases work?
You put it in the vaginal and it secretes ethinyl estradiol daily or etonogestrel daily. The estrogen inhibits ovulation and thickens cervical mucous.
When do these have less risk for thromboembolism that OCPs?
OCPs must go through 1st pass liver metabolism, where estrogen stimulates increased clotting factor synthesis. Circular silastic capsule releases secrete estrogen that does not need to pass through the liver.
Side effects of vaginal contraception?
Vaginitis, break-through bleeding, nausea, breast tenderness, cervical dysplasia and thromboembolism.
When does emergency contraception need to be used to be effective?
Pre-ovulatory period. If used post-ovulation fertilization could have occurred and they do not terminate pregnancy.
How does male contraception work? What do you need to give as replacement?
It inhibits GnRH stimulation of FSH and LH. This prevents spermatogenesis AND testosterone production. You need to supplement testosterone.
How long does it take to get back to baseline after taking oral contraceptives?